Diana Farmer: Seasoned Surgeon

By Chris Vaughan

First published June 2003

Diana Farmer is one of only a handful of surgeons -- and the first female in the world -- to open the womb of a pregnant woman, surgically correct a congenital defect in the fetus and close up the womb so the fetus can finish out the pregnancy. It is a daring surgery with great risks and rewards, the kind of operation that touches on Farmer's passions: helping children and taking on scientific and medical challenges. Even so, Farmer is well aware of the ethical boundaries of this work, and of the reality that she has two patients -- the child and the mother.

"We can't lose sight of the fact that the mother puts her life on the line every time we do fetal surgery," Farmer says. "When she is pregnant, she is vulnerable and willing to do anything for the baby, and it's our job to safeguard both the fetus and the mother." Farmer brings a personal perspective to this problem. She first became interested in the ethical dimensions of medicine -- in fact, first became interested in medicine itself -- by accident. An accident that happened to her.

Farmer has always loved science. At Wellesley she studied marine biology and molecular biology, then did research at Woods Hole Oceanographic Institute, at Stanford, and in Bermuda. Farmer was a Rhodes Scholar finalist in 1976, when it first became available to women. While driving across the country to take her final interviews, Farmer got into a car accident. She was hospitalized for some time and there became interested in medicine -- and medical ethics.

"They told me that I couldn't get on an airplane after the accident, and I didn't realize that I could have said, 'Thank you very much for your advice' and got on a plane," Farmer says. The issues of patient control and consent also arose later, when the doctors told Farmer she would have to decide whether to have surgery. Not having much basis to make such a huge decision left Farmer wondering, "Well, how do I decide that?" she says.

A passion for surgery

With her interest in medicine and ethics, she thought she would pursue a combination law and medicine degree, and so she enrolled in a program at the University of Washington in Seattle. Once there, however, she discovered something that she truly loved: surgery. "I loved surgery from the very first day," she says. "I felt that with surgery I could really make a difference in patients' lives, and surgery involved skills that I had in hand and could take anywhere."

The portability of her surgical skills came in handy for the next stage of Farmer's career, as she moved around the country and around the globe, and from academia to private practice to private industry. After a surgical fellowship in Michigan, Farmer was awarded a Luce Scholarship to study medicine in Asia and moved to Singapore with her husband, a pediatric anesthesiologist. The two have traded off moving for each other's careers, both going to Michigan and Singapore for Farmer, then moving to Philadelphia for her husband's appointment to Philadelphia Children's Hospital. While in Philadelphia, Farmer worked with the NIH on an experimental cancer therapy for DuPont.

All the moving and accommodating of each other's needs has been a juggling act but has been well worth it. "We never wanted to hold each other back," says Farmer. Always one to embrace challenges, Farmer found greater challenges in pediatric surgery. "It's very fine, precise work, very technically
challenging, and you get one chance to get it right."

She found that the rewards of operating on children were also great. "You can have a huge impact on patients' lives," Farmer says. "You don't just save a life, you save a lifetime." The patients are also fun, Farmer says. "My claim to fame is making dressings in their favorite shapes, like butterflies or baseballs."

A child advocate

Farmer says that she never wanted to have children of her own, and that the science was what first attracted her to pediatric surgery at UCSF Children's Hospital. But after working with children and being a mom to her stepchildren, she has become "a total child advocate."

"I'm now really dedicated to health care for kids, to having a stand-alone children's hospital in San Francisco," Farmer says. "It really needs to happen."

Farmer continues to be interested in international medicine, and has gone to Senegal to do pediatric surgery. "One of the great things is that it is like old-fashioned medicine, like the way it should be, with no forms, no insurance companies, just pure patient care."

Although it has been work to squeeze everything in -- her career, her husband's career, a social life, and kids -- Farmer is happy to be able to manage it. "I am truly grateful for living in a time when all these things are possible for women."